Nervenschäden nach robotergestütztem totalen Hüftgelenksersatz: Fallserie mit 29 Patienten

Abstract

In Germany computer-assisted hip replacement (CAHR), e. g., ROBODOC, has been carried out in several thousand cases. After a period of enthusiasm, the technique now faces growing resistance from both patients and physicians. After CAHR many patients complain about persistent pain and problems with walking. Due to these problems, patients very often ask whether they have a nerve injury. In general, it is important to know whether or not there is a specific risk of nerve injuries with CAHR. At present neurological data are inconsistent, and neurophysiological studies have not yet been reported. We have analysed a case series of 29 patients after CAHR with ROBODOC in 30 operated joints. All patients underwent a systematic neurological and neurophysiological examination. In 3 out of 30 operated sites functionally relevant nerve injuries were found, which led to disability in the first year after surgery. Permanent disability due to nerve injury was not found. There is no evidence of a specific risk of nerve injury after CAHR. The incidence of partial and transient nerve damage in the first year after operation might be higher than in classical hip replacement (3.1 %).